How much rates vary
Facilitymedian $457 · 10th to 90th $407 to $1,820Professionalmedian $479 · 10th to 90th $309 to $5,248
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $1,548.82 Typical High $3,090.30 | Facility | None | $331.13 | $1,548.82 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $1,288.25 | Professional | None | $389.05 | $446.68 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | RR · Rental | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | UE · Used equipment | $309.03 | $309.03 | $309.03 |
Blue Shield Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,238.72 | Facility | None | $549.54 | $1,348.96 | $2,238.72 |
Blue Shield Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,905.46 | $3,388.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $741.31 | Professional | None | $338.84 | $371.54 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $338.84 Median $933.25 Typical High $1,023.29 | Professional | None | $338.84 | $933.25 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,621.81 | Professional | None | $562.34 | $660.69 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,897.79 | $4,897.79 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $933.25 | Facility | None | $229.09 | $426.58 | $933.25 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $457.09 | Facility | None | $426.58 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,174.90 | Professional | None | $323.59 | $446.68 | $1,174.90 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where California sits
The same service costs 3.8 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 26th of 51
$457
HI $1,175DE $309
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.